Peggy L Hubbard, PA-C
Individual provider Active NPI Physician Assistant · Deadwood, SD
NPI 1154471282 · NPPES record last updated Feb 5, 2013
Key facts
- NPI
- 1154471282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 71 Charles St
Deadwood, SD 57732 - Phone
- (605) 717-6431
- Fax
- (605) 719-6471
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0336 | SD | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
71 Charles St
Deadwood, SD 57732
Mailing address
353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000
Other providers in Deadwood, SD
- James M Hardwick
- Moon Shadow Jarvis Hemeyer
- Jim Hermeling
- James T Holloway
- Lennard Hopper
- Kay K Huhnerkoch
- Ashley Johnson
- Brett M Johnson
- Keri Lee Johnson
- Donald Howard Kelley
All providers in Deadwood, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.